An intraarterial prosthesis for the repair of AAAs (grafts) is introduced into the AAA through the distal arterial tree in catheter-based delivery systems, and is attached to the non-dilated arteries proximal and distal to the AAA by an expandable framework (stents). An intraarterial prosthesis of this type has two components: a flexible conduit, the graft, and the expandable framework, the stent (or stents). Such intraarterial prosthesis used to repair AAAs is named stent-graft. AAAs typically extend to the aortic bifurcation of the common iliac arteries. There is rarely any non-dilated aorta below the aneurysm. If there is not then the distal end of the graft must be implanted in the lilac arteries, and for the graft to maintain prograde in-line flow to the legs and arteries of the pelvis, it must also bifurcate. Currently available stent-grafts fall into several categories. One category of grafts are those in which a preformed graft (either tube, aorto-mono-iliac or bifurcated) is inserted whole into the arterial system and manipulated into position about the AAA. This is a unibody graft. Another category of stent-grafts are those in which a graft is assembled in situ from two or more stent-graft components. This latter stent-graft is referred to as a modular stent-graft.
The use of modular stent-grafts may be attended by a number of problems. Generally, modular stent-grafts must be compressed for insertion and delivery into the vascular system in a delivery capsule. It will be appreciated that the larger the outer profile of the graft in its compressed condition, the more difficult it will be to insert the device into vasculature and to negotiate the twists and turns of the vasculature. Another significant problem is that, because of the restricted geometry of the vasculature, it can be difficult to insert one element of a modular stent-graft into another. Yet a further problem is that the aorta proximate the renal arteries can lack adequate healthy tissue for forming an attachment of the graft to the aortic wall.
Accordingly, there exists a need to provide a modular graft that can assume a profile better suited for navigating tortuous vasculature, and that is configured to facilitate assembly of its subcomponents. There is a further need to provide an apparatus which can be used where there is insufficient healthy aortic tissue near the renal arteries and which permits a fixation device thereof to be axially rotated with respect to the graft. The device of the present invention addresses these and other needs.